Resection of a pulmonary malignancy invading the intrapericardial inferior vena cava.
Resection of extensive lung cancers invading thoracic vascular structures (T4 lesions) can yield long-term survival provided the margins and nodes are free of tumor. We report the resection of the suprahepatic inferior vena cava for direct tumor involvement by a pulmonary malignancy. The resection was performed without bypass, and the cava was subsequently reconstructed with a 22-mm-diameter Dacron graft. Patency was documented on postoperative magnetic resonance angiograms. The patient was discharged home on postoperative day 10 without complications and remains well 8 months after the operation. Potentially curative resections and reconstructions of suprahepatic inferior vena cava involved with pulmonary malignancies are possible and can be done without cardiopulmonary bypass.
Roberts
J R
JR
Division of Cardiothoracic Surgery, University of Pennsylvania, Philadelphia, USA.
Abbott
P S
PS
Smythe
W R
WR
Bavaria
J E
JE
D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D014682:Vena Cava, Inferior / Q000473:pathology / Q000601:surgery*